The literature illustrates the influence of physical factors on self- esteem and the relationship of self-esteem to mental health and well- being. Two types of low self-esteem, chronic and situationally-induced, have been identified. The literature of Nursing, Psychiatry and Educational Psychology emphasizes self-esteem as a global construct but recognizes that specific alterations in aspects of the self-concept may significantly alter self-esteem. There have been few studies focused on delineating specific aspects of situationally-induced low self-esteem. The proposed study is an initial effort to develop a theory of situational low self-esteem particularly as related to body-image alterations following loss of body part of functioning and disfigurements. Specific aims are to: (1) identify characteristic indicators of situational low self-esteem in patients experiencing body image disruption; (2) identify influencing and contextual factors associated with the phenomenon; and (3) describe the process of maintaining or coping with disruptions in self-esteem as persons adapt to body-image disruptions. A descriptive study is proposed using combined qualitative and quantitative methods to develop a grounded theory of situational self-esteem and body-image changes. The grounded theory approach of Glaser and Strauss (1967) and Strauss and Corbin (1990) will be used. Quantitative measures of global self-esteem (Rosenberg Self-Esteem Scale) and situation-specific self-esteem (Franzoi & Shields Body-Esteem Scale) will be completed initially, and at 6, 12, and 18 months. Trend analysis will be used to analyze patterns of self and body esteem scores over the 18 months. These patterns will be compared to the process of adaptation described in the theory. Correlations between global and body esteem measures at each of the four data collection periods will be used to identify relationships between global and situation-specific self-esteem over the period of adaptation. This study will initiate a program of theory development and research in situational self-esteem.